2007 Community Health Services
System Staffing Summary Report
Introduction
The following report summarizes the 2007 staffing information for the
Community Health Services (CHS) System, submitted by Minnesota’s local
health departments to the Minnesota Department of Health. The staffing
information is categorized by job classification and area of public health
responsibility. Areas of public health responsibility are: health services, healthy
communities, infrastructure, environmental health, emergency preparedness, and
infectious disease. Complete explanations of the job classifications and areas of
public health responsibility can be found in Appendices A and B.
In 2007, there were 75 local public health reporting entities (referred to in this
report as local health departments) in Minnesota. Minnesota’s local public health
system consists of 53 Community Health Boards (CHBs). CHBs are allowed to
decide the jurisdictional level at which they will report their data. For example, a
multi-county CHB could have each county in the CHB report as an individual
county or could choose to report collectively as one CHB. Of the 75 local health
departments included in this report: 28 are single-county CHBs, 9 are multicounty CHBs, 34 are single counties reporting separately within multi-county
CHBs, and 4 are city CHBs.
Per capita and FTEs per 100,000 are calculated based on the 2006 populations
from the State Demographic Center.
The CHBs are split into geographic regions that are used for analysis. Appendix C
contains a map of the regions.
The report is broken down into two sections:
•
•
Statewide results
Regional comparisons
The appendices include:
A. Definitions of the Job Classifications
B. Areas of Public Health Responsibility
C. Map of the CHS System
2007 Local Health Department Staffing Summary Report
Page 1 of 15
Statewide Workforce Results
In 2007, the CHS System employed 2,923 full-time equivalents (FTEs), an increase of
120 FTEs (or four percent) from 2006. One local health department (LHD) accounted for
a significant portion of this increase with 58 more FTEs in 2007. Of the remaining 74
LHDs, 21 had a decrease and 52 had an increase in the number of FTEs. Two LHDs had
no changes. The number of FTEs per 100,000 statewide increased slightly from 2006 to
2007, from 54 to 56.
Figure 1. FTEs by Job Classification and Number of LHDs
with FTEs in each Job Classification
Number of
Percent of
Number of
Percent of
LHDs with
LHDs with
FTEs
Total FTEs
FTEs in job
FTEs in job
Job Classifications
classification
classification
Public Health Nurse
856
29%
73
97%
Administrative
430
15%
73
97%
Support
Other Nurse
304
10%
64
85%
Paraprofessional
258
9%
52
69%
Medical & Public
152
5%
21
28%
Health Social Worker
Public Health
130
4%
51
68%
Educator
Public Health
129
4%
14
19%
Program Specialist
Administrative/
114
4%
48
64%
Business Professional
Environmental
114
4%
30
40%
Scientist & Specialist
Health Administrator
114
4%
74
99%
Public Health
93
3%
36
48%
Nutritionist
Health Planner/
69
2%
15
20%
Researcher/Analyst
Technician
44
1%
17
23%
Other Public Health
22
1%
15
20%
Professional
Service/Maintenance
17
1%
6
8%
Epidemiologist
15
1%
9
12%
Other*
61
2%
68
91%
Total
2923
---*includes occupation safety and health specialist, public health dental worker, public health physician,
public health therapist, mental health counselor, interpreter, licensure /inspection/regulatory specialist, and
other.
2007 Local Health Department Staffing Summary Report
Page 2 of 15
The CHS System is supported by a variety of job classifications (Figure 1). Ninety-seven
percent of LHDs employed public health nurses, accounting for almost 30 percent of the
CHS System workforce. Together, public health nurses and other nurses represented
nearly 40 percent of the workforce. The other largest job classifications were
administrative support (15 percent) and paraprofessionals (nine percent). Fifteen FTE
epidemiologists were in the CHS System workforce in 2007. Only two local health
departments outside the metro region employed epidemiologists.
Figure 2. Total FTEs by Local Health Departments
25
21
Number of Local Health Departments
20
15
14
14
10
9
8
6
5
3
0
<5
5-14.99
15-24.99
25-34.99
35-44.99
45-54.99
>55
Number of FTEs
Figure 2 shows the total number of FTEs by LHD. Seventeen LHDs (23 percent) had less
than 15 total FTEs. The median number of FTEs was 25 with a range of three FTEs to
419 FTEs. The largest two LHDs accounted for 25 percent of the all FTEs and employed
more FTEs than the 43 smallest LHDs combined. All but two of the LHDs employing
more than 55 FTEs were located in the metro region.
Figure 3 represents the FTEs per 100,000 people. Twenty-eight LHDs (37 percent) had
fewer than 50 FTEs per 100,000. The median number of FTEs per 100,000 for local
health departments in Minnesota was 71 with a range from 15 to 352 FTEs. Of the 18
LHDs with the highest FTEs per 100,000 all but two provide home health and all were
located outside of the metro region.
2007 Local Health Department Staffing Summary Report
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Figure 3. FTEs per 100,000 by Local Health Departments
30
26
Number of Local Health Departments
25
20
15
14
15
10
10
8
5
2
0
<25
25-49.99
50-74.99
75-99.99
100-124.99
>125
FTEs per 100,000
Figure 4 shows the number of FTEs statewide working in each area of public health
responsibility. The two largest areas assure health services and healthy communities
accounted for 73 percent of the entire workforce. Below are brief summaries examining
the number and type of staff in each area of public health responsibility.
Figure 4. FTEs in each Area of Public Health Responsibility
Emergency Preparedness,
105
Infectious Disease, 134
Environmental Health, 210
Assure Health Services,
1212
Infrastructure, 317
Healthy Communities, 945
2007 Local Health Department Staffing Summary Report
Page 4 of 15
Emergency Preparedness
Emergency preparedness FTEs accounted for four percent of all FTEs (105 FTEs), a
decrease of 2 percent (2.0 FTEs) from 2006. Twenty-five percent of emergency
preparedness FTEs were public health nurses. Other professions in this area were health
planners (14 percent), administrative support (11 percent), and public health educator (11
percent). Three LHDs had no FTEs in the area of emergency preparedness.
Infectious Disease
In the CHS System, 134 FTEs (five percent for all FTEs) were reported as working in the
area of infectious disease, in increase of eight FTEs from 2006. Nurses, including public
health nurses and others, accounted for 51 percent of the staff in the area of infectious
disease. Other professions included administrative support (18 percent), public health
educators (five percent), and public health program specialist (five percent). It is
important to note that two LHDs accounted for 27 percent of FTEs in the area of
infectious disease. Five LHDs had no FTEs in the area of infectious disease.
Environmental Health
Environmental health was staffed by 210 FTEs, or seven percent of the CHS workforce.
Over half (52 percent) of those FTEs were environmental scientists and specialists. The
remaining occupations represented included licensure/inspection/regulatory specialists
(six percent) and health educators (seven percent). It is important to note that two local
health departments accounted for 35 percent of all FTEs in environmental health. Ten
LHDs had no FTEs in this area.
Infrastructure
Local health departments classified 317 FTEs as working in the area of infrastructure,
which accounted for 12 percent of all FTEs. This area had a decrease of seven percent
(25 FTEs) from 2006. Thirty-eight percent of FTEs were administrative support. Health
administrators (17 percent) and administrative/business professionals (13 percent) also
accounted for a high percent of FTEs. Two LHDs had no FTEs in the area of
infrastructure.
Healthy Communities
Healthy Communities was staffed by 945 FTEs, or 32 percent of the CHS workforce, a
seven percent (64 FTEs) increased from 2006. Public health nurses accounted for 39
percent of FTEs in this area. Other staff in the area of healthy communities included
administrative support (14 percent), public health nutritionists (10 percent), health
educators (eight percent), and other nurses (eight percent). One LHD had no FTEs in the
area of healthy communities.
Assure Health Services
The area of assure health services employed 1,212 FTEs, encompassing 41 percent of all
FTEs in the CHS System. Over 380 FTEs worked in home health services, which
accounted for 32 percent of all assure health services FTEs and 13 percent of total FTEs
in all areas. Nurses, including public health nurses and others, accounted for 49 percent
of FTEs in this area. Other staff included paraprofessionals (19 percent), administrative
support (10 percent), and medical and public social worker (12 percent). Sixty-seven
percent of all other nurses and 44 percent of all public health nurses worked in assure
health services. All but one LHD employed FTEs in this area.
2007 Local Health Department Staffing Summary Report
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Regional Comparisons
Figure 5 shows the total number of FTEs and FTEs per 100,000 population, by region.
The metro region had the most FTEs (1,226) but the smallest number of FTEs per
100,000 (43). All regions had increases in FTEs from 2006, ranging from 49 to 2 FTEs.
Some LHDs outside the metro provided home health services, which contributed to the
higher number of FTEs per 100,000 in Greater Minnesota.
Figure 5. Regional FTEs and FTEs per 100,000 Population
Percent of
FTEs Per
Region
Total FTEs
Total FTEs
100,000
Metro
1226
42%
43
Southeast
425
15%
87
Central
380
13%
54
South Central
193
7%
67
Northwest
179
6%
90
Southwest
175
6%
78
West Central
173
6%
93
Northeast
172
6%
54
Total
2923
100%
56
Figure 6 shows the number of FTEs working in each area of public health responsibility
by region. The area of assure health services accounted for the most FTEs in all regions
except the northeast region. The metro region accounted for over half of the FTEs in the
areas of infectious disease (51 percent) and environmental health (57 percent).
Northeast
Northwest
South
Central
Southeast
Southwest
45
126
25
17
23
38
18
25
317
Healthy
Communities
126
386
60
45
61
136
80
50
945
Infectious Disease
15
68
5
5
7
17
11
7
134
15
120
21
1
12
23
11
6
210
16
47
5
5
7
12
7
6
127
163
478
57
105
83
199
48
79
1190
380
1226
172
179
193
425
175
173
2923
Total
Total
Metro
Infrastructure
Environmental
Health
Emergency
Preparedness
Assure Health
Services
West
Central
Central
Figure 6. Number of FTEs Working in Each
Area of Public Health Responsibility by Region
2007 Local Health Department Staffing Summary Report
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Appendix A:
Definitions of Job Classifications
2007 Local Health Department Staffing Summary Report
Page 7 of 15
Job Classifications
The 2007 Staffing Glossary includes brief definitions and decision guidelines for the
titles in the expanded Bureau of Health Professions listing. The listing was
developed over the course of the enumeration project conducted by Columbia
University School of Nursing Center for Health Policy. These definitions have been
slightly modified to better describe Minnesota’s public health workforce;
modifications have been noted. For the complete report, go to:
www.nursing.columbia.edu/chphsr/pdf/enum2000.pdf
Health Administrator
This single category encompasses all positions identified as leading a public health
agency, program or major sub-unit. This includes occupations in which employees set
broad policies, exercise overall responsibility for execution of these policies, direct
individual departments or special phases of the agency’s operations, or provide
specialized consultation on a regional, district or area basis. Examples of occupations
include department heads, bureau chiefs, division chiefs, directors, deputy directors,
CHS administrator, public health nursing director, and environmental health director.
This does NOT include managers, supervisors, or team leaders.
Administrative/Business Professional
Performs work in business, finance, auditing, management and accounting. Individuals
trained at a professional level in their field of expertise prior to entry into public health.
Examples of occupations include office manager and accountants.
Administrative Support (Including Clerical and Sales)
Occupations in which workers are responsible for internal and external communication,
recording and retrieval of data and/or information and other paperwork required in an
office. Examples of occupations includes bookkeepers, messengers, clerk-typists,
stenographers, court transcribers, hearing reporters, statistical clerks, dispatchers,
license distributors, payroll clerks, office machine and computer operators, telephone
operators, legal assistants, secretaries, clerical support, WIC clerks, and receptionist.
Environmental Scientist and Specialist
Applies biological, chemical, and public health principles to control, eliminate,
ameliorate, and/or prevent environmental health hazards. Examples of occupations
include environmental researcher, environmental health specialist, food scientist, soil
and plant scientist, air pollution specialist, hazardous materials specialist, toxicologist,
water/waste water/solid waste specialist, sanitarian, and entomologist.
Epidemiologist
Investigates, describes and analyzes the distribution and determinants of disease,
disability, and other health outcomes, and develops the means for their prevention and
control; investigates, describes and analyzes the efficacy of programs and interventions.
Includes individuals specifically trained as epidemiologists, and those trained in another
discipline (e.g., medicine, nursing, environmental health) working as epidemiologists
under job titles such as nurse epidemiologist.
2007 Local Health Department Staffing Summary Report
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Health Planner/Researcher/Analyst
Analyzes needs and plans for the development of public health and other health
programs, facilities and resources, and/or analyzes and evaluates the implications of
alternative policies relating to public health and health care. Includes a number of job
titles without reference to the specific training that the individual might have (e.g., health
analyst, community planner, research scientist).
Interpreter
Individuals who translate information in one language to another language for public
health purposes. (This is not an official EEO-4/CHP/BHPr+ definition.)
Licensure/Inspection/ Regulatory Specialist
Audits, inspects and surveys programs, institutions, equipment, products and personnel,
using approved standards for design or performance. Includes those who perform regular
inspections of a specified class of sites or facilities, such as restaurants, nursing homes,
and hospitals where personnel and materials present constant and predictable threats to
the public, without specification of educational preparation. This classification probably
includes a number of individuals with preparation in environmental health, nursing and
other health fields.
Medical & Public Health Social Worker
Identifies, plans, develops, implements and evaluates social work interventions on the
basis of social and interpersonal needs of total populations or populations-at-risk in order
to improve the health of a community and promote and protect the health of individuals
and families. This job classification includes titles specifically referring to social worker.
(This category has been modified from the original occupational title and includes
“Mental Health/Substance Abuse Social Worker.”)
Mental Health Counselor
Emphasizes prevention and works with individuals and groups to promote optimum
mental health. This occupation may help individuals deal with addictions and substance
abuse; family, parenting, and marital problems; suicidal tendencies; stress management;
problems with self-esteem; and issues associated with aging, and mental and emotional
health. It can also provide services for persons having mental, emotional, or substance
abuse problems and may provide such services as individual and group therapy, crisis
intervention, and social rehabilitation. May also arrange for supportive services to ease
patients, return to the community. It includes such titles as community health worker and
crisis team worker. This category excludes psychiatrists, psychologists, social workers,
marriage and family therapists, and substance abuse counselors.
Occupation Safety & Health Specialist
Reviews, evaluates, and analyzes workplace environments and exposures and designs
programs and procedures to control, eliminate, ameliorate, and/or prevent disease and
injury caused by chemical, physical, biological, and ergonomic risks to workers.
Occupations include industrial hygienist, occupational therapist, occupational medicine
specialist and safety specialist. It also includes a physician or nurse specifically identified
as an occupational health specialist.
2007 Local Health Department Staffing Summary Report
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Other Nurse
Helps plan, develop, implement and evaluate nursing and public health interventions for
individuals, families and populations at risk of illness or disability. Other nurses include
nurses with the following titles: RN, NP, and LPN. A nurse that has a baccalaureate or
higher degree with a major in nursing and meets the requirements stated in Minnesota
Rules Chapter 6316 should be classified as a “Public Health Nurse.” (This is not an
official EEO-4/CHP/BHPr+ definition.)
Other Public Health Professional
This includes positions in a public health setting occupied by professionals (preparation
at the baccalaureate level or above) that do not fall under the specific professional
categories. (This category has been slightly modified from the original occupational
title.). Examples of occupations include physician assistant, laboratory professional,
EMS professional, intern, speech therapist, and public relations/media specialist.
Paraprofessionals
Occupations in which workers perform some of the duties of a professional or technician
in a supportive role, which usually require less formal training and/or experience
normally required for professional or technical status. This includes research assistants,
medical aides, child support workers, home health aides, library assistants and clerks,
ambulance drivers and attendants, homemaker, case aide, community outreach/field
worker, and advocate.
Public Health Dental Worker
Plans, develops, implements and evaluates dental health programs to promote and
maintain optimum oral health of the public; public health dentists may provide
comprehensive dental care; the dental hygienist may provide limited dental services
under professional supervision. This category is specific in its inclusion of only
employees trained in dentistry or dental health, but abnormally broad in that it neglects
the professional/technician distinction and includes the entire range of qualifications,
from dental surgeon to dental hygienist.
Public Health Educator
Designs, organizes, implements, communicates, provides advice on and evaluates the
effect of educational programs and strategies designed to support and modify healthrelated behaviors of individuals, families, organizations, and communities. This title
includes all job titles that include health educator, unless specified to another specific
category, such as dental health educator or occupational health educator.
Public Health Nurse
Plans, develops, implements and evaluates nursing and public health interventions for
individuals, families and populations at risk of illness or disability. This title only
includes public health nurses who meet the requirements stated in Minnesota Rules
Chapter 6316. Public health nurses must have a baccalaureate or higher degree with a
major in nursing. (This category has been modified from the original occupational title.)
Public Health Nutritionist
Plans, develops, implements and evaluates programs or scientific studies to promote and
maintain optimum health through improved nutrition; collaborates with programs that
2007 Local Health Department Staffing Summary Report
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have nutrition components; may involve clinical practice as a dietitian. Examples include
community nutritionist, community dietitian, nutrition scientist, and registered dietician.
Public Health Physical Therapist
Assesses, plans, organizes, and participates in rehabilitative programs that improve
mobility, relieve pain, increase strength, and decrease or prevent deformity of
individuals, populations and groups suffering from disease or injury.
Public Health Physician
Identifies persons or groups at risk of illness or disability, and develops, implements and
evaluates programs or interventions designed to prevent, treat or ameliorate such risks;
may provide direct medical services within the context of such programs. Examples
include MD and DO generalists and specialists, some of whom have training in public
health or preventive medicine. This job classification does not include physicians
working in administrative positions (health administrator or official) and some in
specialty areas (epidemiology, occupational health).
Public Health Program Specialist
Plans, develops, implements and evaluates programs or interventions designed to identify
persons at risk of specified health problems, and to prevent, treat or ameliorate such
problems. This job classification includes public health workers reported as public health
program specialist without specification of the program, as well as some reported as
specialists working on a specific program (e.g. AIDS Awareness Program Specialist,
immunization program specialist.) Includes individuals with a wide range of educational
preparation, and may include individuals who have preparation in a specific profession
(e.g., dental health, environmental health, medicine, and nursing).
Service-Maintenance
Occupations in which workers perform duties which result in or contribute to the
comfort, convenience, hygiene or safety of the general public or which contribute to the
upkeep and care of buildings, facilities or grounds of public property. Workers in this
group may operate machinery. This includes chauffeurs, laundry and dry cleaning
operatives, truck drivers, bus drivers, garage laborers, custodial employees, grounds
keepers, drivers, transportation, and housekeeper.
Technicians
This classification includes occupations that require a combination of basic scientific or
technical knowledge and manual skill that can be obtained through specialized postsecondary school education or through equivalent on-the-job training. Examples include
computer programmers, drafters, survey and mapping technicians, photographers,
technical illustrators, technicians (medical, dental, electronic, physical sciences),
inspectors, environmental health technician, nutritional technician, detox technician,
EMS technician, hearing and vision technician, laboratory technician, and computer
specialist.
2007 Local Health Department Staffing Summary Report
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Appendix B:
Areas of Public Health Responsibility
2007 Local Health Department Staffing Summary Report
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Areas of Public Health Responsibility
Assure an Adequate Local Public Health Infrastructure (Infrastructure)
This area of public health responsibility describes aspects of the public health
infrastructure that are essential to a well-functioning public health system – including
assessment, planning, and policy development. This includes those components of the
infrastructure that are required by law for community health boards. It also includes
activities that assure the diversity of public health services and prevents the deterioration
of the public health system.
Promote Healthy Communities and Healthy Behaviors (Health Communities)
This area of public health responsibility includes activities to promote of positive health
behaviors and the prevention of adverse health behaviors – in all populations across the
lifespan in the areas of alcohol, arthritis, asthma, cancer, cardiovascular/stroke, diabetes,
health aging, HIV/AIDS, Infant, child, and adolescent growth and development, injury,
mental health, nutrition, oral/dental health, drug use, physical activity, pregnancy and
birth, STDs/STIs, tobacco, unintended pregnancies, and violence. It also includes
activities that enhance the overall health of communities.
Prevent the Spread of Infectious Disease (Infectious Disease)
This area of responsibility focuses on infectious diseases that are spread person to person,
as opposed to diseases that are initially transmitted through the environment (e.g.,
through food, water, vectors and/or animals). It also includes the public health
department activities to detect acute and communicable diseases, assure the reporting of
communicable diseases, prevent the transmission of disease (including immunizations),
and implement control measures during communicable disease outbreaks.
Protect Against Environmental Health Hazards (Environmental Health)
This area of responsibility includes aspects of the environment that pose risks to human
health (broadly defined as any risk emerging from the environment), but does not include
injuries. This area also summarizes activities that identify and mitigate environmental
risks, including foodborne and waterborne diseases and public health nuisances.
Prepare for and Respond to Disasters, and Assist Communities in Recovery
(Emergency Preparedness)
This area of responsibility includes activities that prepare public health to respond to
disasters and assist communities in responding to and recovering from disasters.
Assure the Quality and Accessibility of Health Services (Assure Health Services)
This area of responsibility includes activities to assess health care capacity and assure
access to health care. It also includes activities relate to the identification and reduction of
barriers to health services. It describes public health activities to fill health care gaps,
reduce barriers and link people to needed services.
2007 Local Health Department Staffing Summary Report
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Appendix C:
Map of Regions
2007 Local Health Department Staffing Summary Report
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Local Public Health Regions
Northwest
Kittson
Lake
of
the Woods
Roseau
Marshall
Koochiching
Beltrami
Pennington
St. Louis
Cook
Red Lake
Lake
Clearwater
Polk
Mahnomen
Norman
Itasca
Hubbard
Northeast
Cass
Becker
Clay
Aitkin
West
Central
Crow
Wing
Wadena
Wilkin
Carlton
Otter Tail
Mille
Lacs
Todd
Grant
Traverse
Pine
Kanabec
Morrison
Douglas
Central
Benton
Stevens
Pope
Stearns
Sherburne
Big
Stone
Swift
Lac
Qui
Parle
Washington
Meeker
Chippewa
Ramsey
Hennepin
McLeod Carver
Yellow Medicine
Renville
Scott
Sibley
Lincoln
Chisago
Anoka
Wright
Kandiyohi
Isanti
Lyon
Redwood
Southwest
Nicollet
Le Sueur
Dakota
Rice
Goodhue
Wabasha
Brown
Pipestone
Rock
Murray
Nobles
Cottonwood
Jackson
Watonwan Blue Earth
Martin
Faribault
Steele Dodge
Waseca
Metro
Freeborn
Olmsted
Mower
Fillmore
Southeast
Winona
Houston
South Central
2007 Local Health Department Staffing Summary Report
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